Perimenopause with no periods to miss
Have you noticed that nearly every article about perimenopause begins the same way? "The first sign is usually a change in your periods." Lovely. Very helpful. If you have periods.
I hadn't had one since I was 19. I was 45. So when perimenopause turned up at my door, it didn't knock. It let itself in, put the kettle on, and I didn't notice for the best part of six months.
Fifteen-year-old me had a plan
My periods, back when I had them, were not periods. They were episodes. Pain that folded me in half, clots, and being sick with it so often that people decided I had an eating problem. I didn't, of course. I had a uterus with a grudge.
So at fifteen I made two decisions. No children, ever. And no more of this, as soon as somebody would let me. I've stuck to the first one. The second one the injection took care of for me from the age of 19, and I have never loved anything the way I loved that injection.
You're supposed to come off it every two years, let your body find its cycle again, which can take six months, and then go back on, to head off a bunch of side effects. I chose not to do that. Not once, in 26 years. Partly because "find its cycle again" is a polite way of saying "bring back the thing you're hiding from". Partly because, in the part of the world I live in, the health system doesn't really approve of contraception, and every three months I had to go and have the same argument to get it. Same chemist. Same face. Same sigh. I could have got a mortgage with less paperwork. I was not about to add "and now I'd like to stop and restart" to that conversation.
Then, after all those years, it was pulled from the shelves. The argument was over, and so was my peace.
The band reunion nobody asked for
A few months later, the periods came back. Not gently. Like a band reuniting for the money: same songs, louder, and the lead singer hasn't aged well. Pain, clots, sick. I wasn't shocked. I remembered them. I'd just hoped they'd lost my address.
Here's the trap, though. For every other woman, a change in her periods is the signpost. Mine had just appeared out of nowhere after 26 years, so what exactly was I meant to notice changing? They were the change. They used up all my attention. And while I was busy with them, the rest arrived quietly round the side.
Itchy ears. Sinuses that gave up overnight. Bread that turned on me. A fog so thick I once forgot how to drive an automatic. A temper you could toast bread with. I've written the full list in another post, so I'll spare you, but at the time I had six separate problems and I was treating them like six separate hobbies. One for the ears, one for the sinuses, a small sideline in washing powder.
Nobody said perimenopause. Why would they? There was nothing to go missing.
The penny drops, in my mum's kitchen
It wasn't a doctor who worked it out. It was my mum, over a cup of tea, while I was listing everything that was wrong with me in the tone of a woman reading out a weather warning.
"Oh," she said. "We all went through that at thirty-eight."
Sorry. We what?
Every woman in my family, it turns out, had gone through the menopause in her late thirties or early forties. All of them. This information had been available for decades and had never once come up, because you don't, do you. She told me the way you'd tell someone the bins go out on a Tuesday.
So at 45 I wasn't early. I was late. I'd been sitting in the waiting room for years with the lights off, wondering why my ears itched.
"And when was your last period?"
Then I went to the doctor, armed with my new theory, and we had the conversation every woman in my position has.
"When was your last period?"
"Nineteen to forty-five, nothing. Then they came back in the winter."
If you ever want to watch a medical professional reboot, that's the sentence. The one question they're trained to open with had an answer that didn't fit the form, and for a moment we both just sat there while the form lost.
I'm not a doctor. I don't know how they're supposed to spot it in someone like me. What I do know is that once that question fails, you're relying on the person in front of you to think past the leaflet. Some do. Some reach for the next leaflet.
Twenty-six years with no practice
Here's the bit nobody mentions. Most women spend thirty years learning how their own hormones behave. The week before, the day of, the fog, the flare, the "don't speak to me until Thursday". Annoying, but it's practice. By 45 they can read themselves like a weather app.
I'd had no practice at all. The injection had flattened everything, and I'd liked it flat. So when the moods started swinging, I didn't have a "this is hormones" folder to file them in. I just assumed I'd become a horrible person quite quickly, which was upsetting, because I'd been quite pleased with the old one.
My family had a name for the woman who came downstairs some mornings: Jekyll and Hyde. Generous, really, because Jekyll rarely made it down. It took me a long time to understand that she wasn't a character flaw. She was chemistry, and chemistry doesn't take it personally.
What to watch, if you've nothing to miss
If you're in the same boat, on the injection, the implant, the coil, after a hysterectomy, anything that's taken your periods out of the picture, this is what I'd say, as one woman to another and not as advice:
Ask your mum. Or your aunt, your sister, your nan if she's still with us and still speaking to you. When did it start for them? It's the most useful thing I learned, and it cost one cup of tea.
Watch everything else. Sleep, temperature, mood, fog, skin, digestion, how much you'd like to throw the toaster. Those are your signposts now. Quieter than a missing period, but they're there.
Write it down. I say this in every post because it's the only thing that worked. A few weeks of notes showed me a pattern that a year of just living through it hadn't. On paper, six problems turned into one.
Say it out loud at the doctor's. "I haven't had periods since I was 19 because of the injection, so I can't tell you about those. Here's what's changed." Then hand over the notes. It moves the conversation off the one question you can't answer and on to the ten you can.
Don't wait for permission. Nobody is going to send you a letter. If you're the right age for your family and your body has started doing new things, perimenopause is allowed to be the answer, even without the paperwork.
The upside, such as it is
There is one. Twenty-six years with no periods meant no flooding, no surprise ambush on a beach, no whispered negotiations with strangers in a service-station toilet. A lot of women get their worst, heaviest, most chaotic cycles in their forties. I got mine in one lump at the end, with the ears thrown in free, and I'm not calling that a win. But I had 26 quiet years, and I'd take them again tomorrow.
The other upside is you. If your periods vanished years ago and you now feel like a stranger in your own body, you're not imagining it, you haven't turned into a horrible person, and you're not the only one who had to work it out backwards over a cup of tea. I did. It's doable. It's just not in the leaflet.
If this sounded familiar, there's more where it came from. I send a note like this once or twice a month (the sign-up is at the bottom of this page), and the Hot Mess Community is where we carry on the conversation.
Emma
Hot Mess is a tracking aid, not a medical device, and none of this is medical advice. Very heavy or painful periods, clots and being sick with them are worth a doctor's visit in their own right, whatever your age, and perimenopause is one explanation for new symptoms, not the only one.